Shelby Drugstore, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10044 Issued in NC

Legal business name

SHELBY DRUGSTORE, INC.

Practice address

701-1 East Grover Street
Shelby, NC 28150

Phone

(704) 487-2939

Fax

(704) 487-2811

NPI assigned

Apr 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Brooks, RPHNPI 1992114862

Title

Pharmacy Manager

Phone

(704) 487-2939

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Tax ID family

Shelby Drugstore Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shelby Drugstore, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Shelby, NC
  • NPI 1538569744
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Brooks, RPH

  • Pharmacist
  • Shelby, NC
  • NPI 1992114862
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1972776573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701-1 EAST GROVER STREET",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28150",
            "telephone_number": "704-487-2939",
            "fax_number": "704-487-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701-1 EAST GROVER STREET",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "28150",
            "telephone_number": "704-487-2939",
            "fax_number": "704-487-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY DRUGSTORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2023-03-07",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "704-487-2939",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC0235932",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235932",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Associates in Psychiatry, P.a.
• Shelby Bone and Joint Clinic, P.a.
• Shelby Children'S Clinic
• Shelby Chiropractic PLLC
• Shelby Drugstore, Inc.
• Shelby Eye Centers, P.a.
• Shelby Family Practice
• Shelby House LLC
• Shelby Internal Medicine, Inc
• Shelby Manor

• All providers in Shelby, NC
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.